William David Iveson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP014480 Issued in PA

Practice address

271 Grand St
Susquehanna, PA 18847-1511

Phone

(607) 221-1318

Fax

(570) 853-3008

NPI assigned

Nov 10, 2014

Last updated

Nov 10, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wiveson@nepachc.medentdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• B-K Health Center, Inc

  dba NEPA Community Health Care

  • Federally Qualified Health Center (FQHC)
  • Montrose, PA
  • NPI 1619352978
  Medicare reassignment NPD
• B-K Health Center, Inc

  dba NEPA Community Health Care

  • Federally Qualified Health Center (FQHC)
  • Hallstead, PA
  • NPI 1245272707
  NPD
• Barnes-Kasson County Hospital

  • Rural Health Clinic/Center
  • Honesdale, PA
  • NPI 1659180388
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1205232709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 GRAND ST",
            "city": "SUSQUEHANNA",
            "state": "PA",
            "postal_code": "188471511",
            "telephone_number": "607-221-1318",
            "fax_number": "570-853-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 GRAND ST",
            "city": "SUSQUEHANNA",
            "state": "PA",
            "postal_code": "188471511",
            "telephone_number": "607-221-1318",
            "fax_number": "570-853-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVESON",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-10",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Lee Ellis, RDN LDN
• Family Health Clinic Inc (Susquehanna Family Health Clinic Inc)
• Ariele Garofalo, PSY.D.
• Laura Anne Goble, RD, LDN
• Judith Herschel
• Nancy Koberlein, CRNP
• Sara Kolenda
• Tyler Lauffer, FNP-C
• Joseph Lucchesi, DMD
• John Marichak

• Family Nurse Practitioner in Susquehanna, PA
• Providers in Susquehanna, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.